10,000 pharmacists rally in Seoul over government plan to expand drug delivery

"The lives and safety of the people are not fodder for private commercial platforms."

About 10,000 pharmacists and pharmacy students in white coats gathered at Gwanghwamun in Seoul on Sunday for the National Pharmacists' Rally, organized by the Korean Pharmaceutical Association. The association had initially expected 5,000 attendees, but organizers counted roughly 7,000 pharmacists and 3,000 pharmacy students who took to the streets. Their demand: that the government scrap its plan to expand home delivery of prescription drugs to patients who receive telemedicine consultations.

Korean Pharmaceutical Association President Kwon Young-hee directly criticized the government's policy at the rally. "The lives and safety of the people are not fodder for private commercial platforms," she said, adding that the association could no longer stand by while the government put industrial promotion and the profits of private platforms ahead of public health. The association has argued that expanding drug delivery would encourage "medical shopping" and the misuse of medications, and could ultimately make pharmacies and patients dependent on private platforms.

The association directed particular criticism at the Ministry of SMEs and Startups. "Why is the Ministry of SMEs and Startups — which prioritizes industrial logic — joining hands with the telemedicine industry council to dictate healthcare policy that is directly tied to people's lives?" Kwon said at the rally. The association said it had lodged protests with the Ministry of Health and Welfare, the Ministry of SMEs and Startups and the Office for Government Policy Coordination, and announced it would not participate in the cross-ministry public-private consultative body the government plans to establish.

Pharmacy students added their voices to the protest. Kim Baek-geon, president of the Korean Pharmacy Students' Association, asked who would be held responsible if medications were damaged or mixed up with another patient's prescription inside a private delivery network driven by profit. The students argued that questions of liability — covering misdeliveries, quality control and personal data breaches — must be resolved before any expansion moves forward.

The dispute traces back to Aug. 20. The National Assembly that day passed a revision to the Pharmaceutical Affairs Act restricting telemedicine platform operators from entering the drug wholesale business — a measure the industry dubbed the "Doctor Now Prevention Act" after the telemedicine platform Doctor Now, which had been operating a drug wholesale business. The revision added telemedicine intermediaries to the list of entities barred from obtaining wholesale drug licenses, and also prohibited wholesalers with special relationships to such platforms from supplying drugs to pharmacies that had signed service agreements with those platforms.

The Korean Pharmaceutical Association welcomed the bill's passage, saying it had "blocked the conflict of interest arising from telemedicine intermediaries entering the drug wholesale business." The Korea Venture Business Association pushed back the following day, calling it "the strongest form of prohibition legislation — one that fundamentally bans a specific business model outright." The association said a small startup innovation had been "frustrated by entry regulations in a new industry sector and the vested interests of professional associations."

The same day the revised Pharmaceutical Affairs Act cleared the Assembly, however, the government announced it would begin discussions on expanding home drug delivery to all telemedicine patients — reigniting the conflict. The government signaled that while it was using legislation to block platforms from the drug wholesale business, it would separately pursue expanding the range of patients eligible to receive prescriptions at home.

Under a revised Medical Act taking effect Dec. 24, patients eligible for home drug delivery are limited to residents of islands and remote areas, long-term care recipients, people with disabilities, infectious disease patients and those with rare diseases. The government said it would discuss broadening that eligibility and would form a cross-ministry public-private consultative body involving the Ministry of Health and Welfare, the Ministry of SMEs and Startups, the Office for Government Policy Coordination, pharmacist groups and telemedicine platform operators.

The Korea Startup Forum's telemedicine industry council said Monday it was not calling for unconditional expansion of home drug delivery and agreed that sufficient safeguards must be in place. The council said the debate should not be framed as a binary choice between full approval and full prohibition, but rather as a process of establishing patient safety standards one by one — covering how pharmacists provide medication counseling, identity verification of recipients, tracking and management during delivery, drug quality control, and accountability frameworks in the event of an incident.

The council also addressed the pharmaceutical community's concerns about growing platform influence. "We do not take lightly the concerns about unfair platform practices and the risk of pharmacies becoming dependent on platforms," it said, adding that it would examine areas requiring self-correction and actively participate in discussions to establish the necessary regulatory standards and safeguards.

The council also called on the Korean Pharmaceutical Association to join the talks. "Concerns are precisely why dialogue is needed," it said. "Repeating each side's position through statements and press releases alone will make it difficult to build a drug delivery system that guarantees both patient safety and access to medication."

The telemedicine industry council also raised the issue of patient access. It argued that the current system — which allows patients to receive telemedicine consultations but still requires them to visit a pharmacy in person to collect their prescription — runs counter to the purpose of telemedicine.

"The difficulties faced by patients who have received a prescription but cannot easily pick up their medication — whether due to childcare or caregiving responsibilities, or because it is nighttime or a holiday — must be considered in the design of the system, not just those in medically underserved areas or with limited mobility," the council said. It added that patient safety and medication access are not an either-or choice but values that must be achieved together.

Patient and consumer groups have voiced similar concerns. The Korea Consumer Federation and the Korea Patients' Association said on Sept. 9 that telemedicine is complete only when it includes medication delivery. Those groups, however, also urged caution about excessive platform influence, calling on the government to design a safe delivery system and strictly regulate unfair inducement and referral practices by platforms.

The government has taken a cautious stance. Kwak Sun-heon, the Ministry of Health and Welfare's director general for health and medical policy, said on Sept. 3 that the principle was to first verify safety and a neighborhood-pharmacy-centered market order through the limited rollout in December. The government is also reviewing a plan to give pharmacists the choice of delivery provider, keeping the system centered on neighborhood pharmacies and preventing them from becoming dependent on platforms.

How to compensate pharmacists for their role if drug delivery expands is another point of contention. The Ministry of Health and Welfare is reviewing plans to strengthen remote medication counseling via phone or video in telemedicine settings and to provide additional reimbursement for such services — ensuring that pharmacists' counseling function is not diminished even when patients no longer visit the pharmacy in person.